Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort
Authors: Arn Migowski
Journal: Annals of Internal Medicine (2022)

LettersOctober 2022Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening CohortArn Migowski, MD, PHS, MPH, DrPHArn Migowski, MD, PHS, MPH, DrPHCancer Early Detection Division, National Cancer Institute, and National Institute of Cardiology, Ministry of Health, Rio de Janeiro, BrazilSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0273 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Ryser and colleagues (1) present a well-crafted modeling study on breast cancer screening. This study does show advances in relation to previously published models, such as the ability to stratify cases of overdiagnosis into indolent and progressive types of cancer. By accommodating an indolent fraction of preclinical disease, the authors underestimated the overdiagnosis to a lesser extent than previous modeling studies (2).Like any modeling study, Ryser and colleagues' article includes many assumptions and involves indirect evidence, which reduces the strength of the evidence for clinical decision making. The sojourn time estimate is much higher than that ...References1. Ryser MD, Lange J, Inoue LYT, et al. Estimation of breast cancer overdiagnosis in a U.S. breast screening cohort. Ann Intern Med. 2022;175:471-78. [PMID: 35226520] doi:10.7326/M21-3577 LinkGoogle Scholar2. Migowski A, Nadanovsky P, Vianna CM de M. Estimation of overdiagnosis in mammographic screening: a critical assessment. Revista Brasileira de Cancerologia. 2021;67:e-151281. doi:10.32635/2176-9745.RBC.2021v67n2.1281 CrossrefGoogle Scholar3. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209-49. [PMID: 33538338] doi:10.3322/caac.21660 CrossrefMedlineGoogle Scholar4. Migowski A, Silva GAE, Dias MBK, et al. Guidelines for early detection of breast cancer in Brazil. II—New national recommendations, main evidence, and controversies. Cad Saude Publica. 2018;34:e00074817. [PMID: 29947654] doi:10.1590/0102-311X00074817 CrossrefMedlineGoogle Scholar5. World Health Organization. The Global Health Observatory. Life expectancy at age 60 (years). 2022. Accessed at www.who.int/data/gho/data/indicators/indicator-details/GHO/life-expectancy-at-age-60-(years) on 25 April 2022. Google Scholar Author, Article, and Disclosure InformationAuthors: Arn Migowski, MD, PHS, MPH, DrPHAffiliations: Cancer Early Detection Division, National Cancer Institute, and National Institute of Cardiology, Ministry of Health, Rio de Janeiro, BrazilDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L22-0273. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEstimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Marc D. Ryser , Jane Lange , Lurdes Y.T. Inoue , Ellen S. O’Meara , Charlotte Gard , Diana L. Miglioretti , Jean-Luc Bulliard , Andrew F. Brouwer , E. Shelley Hwang , and Ruth B. Etzioni Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Per-Henrik Zahl and Karsten Juhl Jørgensen Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Charles Harding , Dmitriy Burmistrov , Marybeth Pompei , Francesco Pompei Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Sherwin Chiu , Benjamin Williams , Kevin Shahbazian , Michelle V. Lee Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Marc D. Ryser and Ruth B. Etzioni Metrics October 2022Volume 175, Issue 10Page: W114KeywordsBreast cancerBreast cancer screeningCancer epidemiologyCancer screeningMammographyNatural history of diseaseOverdiagnosisPrevention, policy, and public health ePublished: 18 October 2022 Issue Published: October 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...